ARMY CAPT. BRENDAN MACKIE, DELAWARE ARMY NATIONAL GUARD DELIVERING IMPACT AND VALUE COVID-19 HEALTHCARE COALITION MEMBERS REPORT

JULY 2020 MAKING A DIFFERENCE TOGETHER In mid-March, the COVID-19 Healthcare Coalition was established as a coordinated public-interest, private-sector response to the COVID-19 pandemic, convening healthcare organizations, technology firms, nonprofits, academia, and startups. Today, Coalition contributors continue to actively work together on strategies to preserve the healthcare delivery system and protect people. Thank you for your incredible While we have a long way to go before this crisis is over, the Coalition’s close to 1,000 member organizations and thousands of staff remain committed DELIVERED support and the impact you are to making a difference together. 675,000 masks What do you do first when confronted with challenges on somany fronts? The Coalition worked quickly to build a rapid response to immediate crises VALIDATED N95 mask making during this worldwide crisis. like providing personal protective equipment (PPE) for healthcare workers. At the same time, we stood up the critical infrastructure to enable collaboration decontamination and shared analytics. And in the roughly four months following our formation, strategies You are graciously sharing your time, the Coalition has made an impact on the COVID fight, creating resources and tools that can evolve and endure as this challenge continues. relationships, and knowledge to DEVELOPED PPE SUPPORTING THE COVID-19 SUPPLY CHAIN demand model Leveraging the Coalition’s network, we identified quality manufacturing sources, preserve the healthcare delivery negotiated low prices, worked around numerous export challenges, and were able to deliver 675,000 masks to over 60 locations during a time when 50% CONNECTED of hospitals in New York City were running out of N95 respirators. Through the suppliers to buyers system and help protect people. partnership of the charity Masks4America, these masks went to hotspots including Illinois, Virginia, Maryland, Louisiana, Michigan, Washington, D.C., and Puerto Rico. The Coalition also helped to accelerate production of 10,000 low cost ventilators, Together, we’re making a difference. and aggregated a marketplace catalog to provide buyers the simplest possible access to the many PPE marketplaces that have emerged across the country. Where the supply chain wasn’t able to deliver resources, we also provided guidance to help healthcare systems with the difficult choices around alternatives and reuse. Dr. John Halamka The Coalition helped get the word out quickly on the best possible methods for sanitizing N95 masks for multiple reuse, and published “how-to” guidance on President of Mayo Clinic Platform available N95 respirator decontamination strategies. Stanford University, with support from other organizations, is piloting an N95 alternative with health systems Dr. Jay Schnitzer across the country—a modified snorkel mask that filters better and is more cost Chief Medical | Technology Officer at MITRE effective than the original N95 masks. As part of the Coalition’s efforts to accelerate new technologies that could promote reuse and replenishment of resource-limited PPE, we engaged with a UV curing company called INPRO Technologies. With assistance from Coalition scientists, an open source ultraviolet germicidal irradiation design is progressing through FDA emergency use authorization. To help decision makers start to prepare for the challenges ahead, members including Cardinal Health, GHX, LLamasoft, LogicStream Health, MITRE, and Sodexo Healthcare Services came together to develop a PPE and pharmaceuticals demand model. State and local leaders are using this demand model to determine if current PPE stocks are sufficient to satisfy expected demand.

1 INFORMING COORDINATED SOCIAL POLICIES Informed by the National Governors Association Roadmap to Recovery, A landscape analysis has been completed to outline the potential use cases, the Coalition team developed and is supporting ongoing development of end-to-end process, stakeholders, and technical challenges associated with the COVID-19 Decision Support Dashboard. wastewater-based epidemiology (WBE) for COVID-19. The Coalition is collaborating with Oak Ridge Associated Universities, the Thurgood Marshall College Fund, This tool synthesizes large amounts of complex, essential data into easy-to-use and Hispanic Association of Colleges and Universities to connect universities key findings for public and private-sector leaders navigating the “reopening” interested in launching WBE programs with leading experts at Yale University, of communities and businesses. It provides a structured understanding of how a Rice University, and Arizona State University. We are also partnering with the DEVELOPING state or county is performing by adding red-yellow-green indicators for key areas. Start Coalition, to identify partners to launch pilot projects for using WBE the COVID-19 Additional data dashboards from the Coalition provide understanding of the in vulnerable communities. Decision Support secondary effects of key decisions including a critical dashboard focused on identifying vulnerable populations—all free, and built with publicly available Dashboard data and models. Topics covered include NPI implementation, dis/mis information, hotspot detection, short-term forecasting, and regional analysis and comparison. TM PROVIDING insights These dashboards were developed with input, partnership, and data from many members, including: on the impact of • Esri social policies • Jataware • LLamasoft • SafeGraph PROMOTING • Surgo Foundation innovation in testing • Tableau and contact tracing Coalition members have come together to understand and support many of the testing and contact tracing needs and solutions that are emerging to support public and private sector leaders.

One of the tools presented to the coalition is Sara Alert™, a standards-based, open source tool that automates the process of public health monitoring and reporting of individuals exposed to or infected with COVID-19. Sara Alert was developed by MITRE in partnership with national public health organizations, and is currently being deployed in close to 20 jurisdictions, including Pennsylvania, Vermont, Virginia, Arizona, and Puerto Rico. COVID Aware is a no-cost automated proximity notification app to addressone of the biggest gaps in contact tracing: identifying exposure from strangers. COVID Aware provides a free, open-source tool developed for public health agencies to tailor for their own needs and offer to their residents. It frees up critical personnel for other aspects of disease mitigation and response and builds in strong protections for privacy, information security, and anonymity through a reliance on MIT-developed Private Automated Contact Tracing (PACT) protocol using Apple | Google Exposure Notification Service technology.

2 3 POWERING DATA-DRIVEN CLINICAL INSIGHTS Leading companies in health data analytics and vendors, including Allscripts, , , Epic, Health Catalyst, and MITRE, are working together to investigate potential therapeutics to prevent and treat COVID-19. The Coalition has created a de facto COVID-19 data standard to facilitate rapid sharing of outcomes and federated analytics on the effectiveness of treatments such as remdesivir, convalescent plasma, and famotidine as well as reinfection rates. UNLOCKING Coalition members have led the nation’s efforts to pursue research and treatment with blood plasma from convalesced COVID-19 patients. Members of the coalition large-scale analytics including Mayo Clinic, Michigan State University, Amazon, and others are supporting for COVID-19 the country’s largest medical study on COVID-19 patients receiving convalescent plasma treatments. This was followed up with a national plasma donation campaign (The Fight Is In Us) supported by the CoVIg-19 Plasma Alliance, American Association ADVANCING of Blood Banks, American Red Cross, Grifols, Bill and Melinda Gates Foundation, Mayo Clinic, Michigan State University, Uber, and many more. The website was convalescent developed by Coalition members Microsoft and MITRE, and was promoted by plasma research celebrities, including Dwayne “The Rock” Johnson, Helen Mirren, Samuel L. Jackson, Awkwafina, Ken Jeong, Daniel Dae Kim, and Ryan Tedder. COLLABORATING on As telemedicine has surged during COVID-19, we are rapidly sharing insights, educating on waivers and policy changes, and collectively studying the scope best practices and and scale of this unprecedented growth in remote and virtual healthcare. protocols Our weekly Executive Forums convene leaders in the telemedicine ecosystem to solve real-time challenges in expanding telehealth rapidly, enabling health systems to expand medical capacity and patient care during the outbreak. Additionally, Coalition members have launched the COVID-19 Telehealth Impact Study to track the use of telehealth using claims data and surveys of providers and patients. Collaborators include provider organizations, Change Healthcare, The American Medical Association, The American Telemedicine Association, The Massachusetts Health Quality Partnership, The Digital Medicine Society, and others. Finally, Coalition members continue to work collaboratively to understand and address disparities and treat vulnerable populations using virtual modalities, connecting patients to care virtually when and where they need it most.

Our weekly COVID-19 Healthcare Coalition Response Webinar convenes hundreds of technology, social policy, and healthcare system leaders to showcase activities and accomplishments. Participants drive productive and candid discussions of best practices and protocols, and sharing of insights.

4 5 EMPOWERED WITH TECHNOLOGY TO COLLABORATE IN NEW WAYS As sharing data-driven insights was a key objective of the Coalition, we needed a substantial infrastructure to collaborate, collect, analyze, visualize, and share data and insights from close to 1,000 member organizations in a trusted and secure manner. We envisioned an infrastructure that would quickly provide members and many other stakeholders with tools and information they could use to make BUILT critical decisions on how to keep their populations safe. We achieved that vision within weeks thanks to the leadership and extraordinary infrastructure to contributions of members, including: enable collaboration • Acumen and shared analytics • Amazon Web Services • Box • Deloitte LAUNCHED public • Google website with • Microsoft • MITRE useful decision aids • Okta and dashboards • Salesforce • Slack • Splunk CONVENED leading • Tableau technology firms in In collaboration with these and other outstanding technology partners, the Coalition rapidly stood up a cloud-native platform that today supports a public website with service of the public hundreds of curated resources, a member database, as well as a member site where interest data is safely shared for collaborative research. In our first four months, we logged more than 110,000 page views and more than 15,000 views of the Decision Support Dashboard. Thousands downloaded and shared our resources on respirator decontamination. The public site currently houses more than 300 curated resources and best practices.

6 5 7 MOVING FORWARD As COVID-19 shows little signs of waning, new challenges continue to emerge. The Coalition is shifting from emergency actions to building and sustaining the most important enduring capabilities that help fight the adverse impacts of this pandemic. Working groups and project teams are actively pursuing efforts that can drive that enduring impact. We have also acknowledged and identified the health disparities in how COVID-19 is unduly affecting vulnerable populations, particularly across racial and ethnic minority groups. We are committed to ensuring the Coalition’s efforts are part of the solution in achieving greater health equity. You have graciously shared your time, effort, relationships, and knowledge. We hope you can clearly see the positive impacts your contributions have made, and that you are able to continue to participate as we enter a new phase of COVID-19’s impact on society.

IN APPRECIATION FROM MITRE When asked by Coalition founders to take on the operations of the COVID-19 Healthcare Coalition, MITRE was eager to contribute. We are humbled by the depth of member contributions and the power of this community to make a difference during this pandemic. We are honored to serve with the private sector to help address this public challenge and are committed to continuing this effort with a renewed focus on enduring impact as the pandemic continues to spread across the United States. Thank you for your continued commitment to the greater good. Please reach out to us anytime at [email protected] SALUTING OUR MEMBERS

8 9 COVID-19 HEALTHCARE COALITION MEMBERS The COVID-19 Healthcare Coalition has more than 900 member organizations, many of which are working behind the scenes on technology, research, and collaborative projects. Listed below are the organizations who wished to publicly acknowledge their membership.

2THEDGE Clinical Architecture HealthRounder Medallia Pfizer Systems Evolution Alliance for Artificial Intelligence Collaborate Hexoskin Medidata PhenoMx SyTrue in Healthcare Columbia International Hispanic Association of Colleges Mediktor Philips Tableau Alliant Health Group eHealth Laboratory & Universities Medius Health PointClickCare Teladoc Health Allscripts CommonWell Health Alliance Hyland Healthcare Medtronic Prism Health AI TensorX Amazon Web Services ConnectedDMV IBM Watson Health Metadvice Purdue University Teradata Ambient Clinical Analytics ConsenSys Health iMedrix Microsoft Qardio Texas e-Health Alliance American Telemed (ATA) CoronAlert Imprivata MITRE QueueDr The Center for Supply Chain Ames Laboratory CoronaTrace Infinite Leap Moving Analytics Quire Research® - Penn State Smeal College of Business Amoroso and Associates Cotiviti Informatica mTelehealth Rauland The City of London, Canada Apervita COVID SafePaths Innovaccer National Association of Readiness Rounds Aptima Cox Business Innovation Incubator Chain Drug Stores The Global Center for Health Red Hat Security at the University of Arcadia.io Define VC Innovu National Council for Prescription Redflag Artificial Intelligence Nebraska Medical Center Drug Programs Artifact Health Deloitte In-Q-Tel Regenstrief Institute The Handoff Company National Language Service Corps athenahealth Designing for Analytics Insilico Medicine Reingold The Pew Charitable Trusts Netrias Atlas Research Diagnostic Robotics Instant Access Medical Holdings Relias Topo.ai NeuroFlow Atrius Health DXC Technology Intel Corporation Resilinc Traction & Scale NewWave Avecin Efiia Intelligent Medical Objects rfxcel Trapollo NextGen Healthcare Avery Dennison Medical Endpoint Health Intermountain Healthcare RGI-Informatics Trella Health Nference Aviv Growth Partners Corporation IQVIA Robert Morris University TREND Community Nightingale Partners Aya Healthcare Esri Jataware Rtsync Corp Uncharted Software Baptist Health Physician Partners Eureka.AI Kaplan Test Prep Northeastern University, Healthcare Systems Engineering Institute RUSH University System for Health Unite Us BBF Consulting Expii Karuna Health Northwestern University Feinberg Sachs Policy Group Universidad Central del Caribe Beacon Healthcare Systems FairWarning KPN School of Medicine SafeGraph University College London Bicgen Frontive Kryptowire NThrive Salesforce University Industry Development Biodesix Fruit Street Health LabCorp Nutanix SAP Program (UIDP) BlackThorn Therapeutics Fusion Consulting Lantana Consulting Group Nutrimedy SAS University of Bordeaux Blockit Geneia LEAD Coalition Oak Ridge Associated Universities SCP Health University of California at Davis Boston Medical Center Genentech Leavitt Partners Oasis Labs Sequoia Applied Solutions University of California Health Systems Boston University Genialis Leidos Health Group Odgers Berndtson Simeio University of Maryland Bottomline Technologies Georgia Tech Research Institute LetsGetChecked Okta Simudyne University of Mississippi Box Global Healthcare Exchange (GHX) LHKO Skyscape Old Dominion University Virginia Medical Center Brainworks.ai GoInvo Lightbeam Health Solutions Modeling, Analysis, Slack and Simulation Center Uphold Health Buchanan Ingersoll and Rooney Google LLamasoft SOC Telemed Omelas US Civilian Corps Buoy Health Greenway Health LMI Consulting Sodexo Health Care Services Option Care Health Validic BurstIQ GYANT Logi Analytics SparkBeyond VANGUARD Coordinated LogicStream Health Optum C3.ai Harrisburg University of Science Splunk Registry Network and Technology Lumeris OSF HealthCare California Institute of Technology St. Clair Hospital Vcinity HBI Solutions Mahler Health Oura Cardinal Health St. Elizabeth Healthcare Veradigm hc1 MasksForDoctors OZ Systems Caresyntax St. Onge Versatile MED Analytics HCA Healthcare Massachusetts Institute Palantir CassBeth Starschema Virta Labs Health Catalyst of Technology Pandexio Cedars-Sinai Health System Stella Technology Well Health Health Data Decisions MassChallenge Partners Healthcare Cerner Corporation Strata Decision Technology West Monroe Partners Health Gorilla MayaMD PathogenDx Center for Mind and Culture Strategic Marketplace Initiative Wolters Kluwer Health Level Seven International Mayo Clinic PatientLink Change Healthcare Supply Chain Sherpas Workato Health Note MazikGlobal Pegasystems Chartis SURE Universal XIFIN HealthEC Mazzetti Persistent Systems CitiusTech Surgo Foundation ZealStrat Healthmonix McMenamin Law Offices Personal Remedies 10 Citus Health Symphony Ayasdi Zeblok Computational 11 Zocdoc COVID-19 HEALTHCARE COALITION WORKING GROUPS Mayo Clinic OSF HealthCare Global Healthcare Exchange Karuna Health MITRE Prism Health AI Google LabCorp We’d like to acknowledge the organizations and individuals who have donated significant Partners Healthcare Redflag Artificial Intelligence Health Catalyst Leavitt Partners time and resources to the Coalition in their specific technical specialties. Working Groups Rtsync Corp IBM Watson Health Leidos Health Group DIGITAL GUIDELINES are dynamic within the Coalition and evolve over time as priorities and needs shift. SafeGraph Intermountain Healthcare Lightbeam Health Solutions Allscripts SAS Leavitt Partners MassChallenge Apervita Simudyne LLamasoft MayaMD ANALYTICS IQVIA COALITION INFRASTRUCTURE Cedars-Sinai Health System SparkBeyond LMI Consulting, LLC Mayo Clinic Alliance for Artificial Intelligence Jataware 2THEDGE Cerner Corporation TensorX LogicStream Health MazikGlobal in Healthcare KPN Deloitte Clinical Architecture TREND Community Mayo Clinic Alliant Health Group LabCorp Google Intermountain Healthcare University College London Medtronic McMenamin Law Offices Ambient Clinical Analytics LHKO MITRE KPN University of Bordeaux MITRE Mediktor Arcadia.io Lightbeam Health Solutions Okta Mayo Clinic NACDS Microsoft athenahealth Massachusetts Institute of Technology Salesforce.com MITRE N95 AND PPE (SUPPLY CHAIN) Oak Ridge Associated Universities MITRE Amazon Web Services Medidata Simeio SEI Atlas Research Palantir NThrive Beacon Healthcare Systems Mediktor Slack California Institute of Technology Philips Option Care Health DIS/MIS INFORMATION Fusion Consulting BlackThorn Therapeutics Metadvice Splunk Purdue University Optum Aptima Blockit MITRE Tableau Leavitt Partners Red Hat California Institute of Technology PatientLink Boston University Netrias MITRE Resilinc Global Disinformation Index Pfizer BurstIQ Nightingale Partners CONTACT TRACING Purdue University rfxcel LHKO PhenoMx C3.ai Northwestern University Feinberg Avecin Sachs Policy Group MITRE NPIs Reingold Cardinal Health School of Medicine Buoy Health SAP Omelas Designing for Analytics SAS Caresyntax NThrive CitiusTech SCP Health Pandexio Intermountain Healthcare Cedars-Sinai Health System Nutanix ConsenSys Health Sequoia Applied Solutions SCP Health Redflag Artificial Intelligence Jataware Center for Mind and Culture Oasis Labs CoronAlert Sodexo Health Care Services Skyscape Tableau MITRE Change Healthcare Optum COVID SafePaths St. Clair Hospital SOC Telemed Regenstrief Institute & Indiana CitiusTech Partners Healthcare Epic Systems Corporation The Pew Charitable Trusts St. Elizabeth Healthcare Health Information Exchange St. Onge Collaborate Prism Health AI Eureka.AI mCOVID Tableau Strategic Marketplace Initiative Teladoc Health ConsenSys Health Purdue University HealthEC Allscripts Uncharted Software Supply Chain Sherpas Trapollo CoronAlert Rauland Infinite Leap athenahealth TensorX University of California Cotiviti Redflag Artificial Intelligence Intel Corporation Cerner Corporation OPTIMIZATION OF CLINICAL The Center for Supply Chain Health Systems COVID SafePaths Regenstrief Institute & Indiana Health Lantana Consulting Group Research® - Penn State Smeal Information Exchange CitiusTech THERAPEUTICS AND PROTOCOLS University of Mississippi Deloitte Mediktor College of Business Medical Center Clinical Architecture Allscripts Designing for Analytics RGI-Informatics Microsoft Traction & Scale Columbia International eHealth athenahealth Well Health RUSH University System for Health MITRE Virta Labs Diagnostic Robotics Laboratory Cerner Corporation Zocdoc SafeGraph Oak Ridge Associated Universities Efiia Epic Systems Corporation CitiusTech SAP Odgers Berndtson TELEHEALTH TESTING Endpoint Health Health Catalyst Clinical Architecture Esri SAS OSF HealthCare Alliance for Artificial Intelligence athenahealth MITRE Columbia International eHealth SCP Health Oura in Healthcare Eureka.AI Veradigm Laboratory Blockit SparkBeyond Purdue University Alliant Health Group FairWarning Epic Systems Corporation DXC Technology St. Clair Hospital Regenstrief Institute & Indiana American Telemed (ATA) Fusion Consulting MODELING AND SIMULATION Health Catalyst hc1 Starschema Health Information Exchange Atrius Health Genentech Ames Laboratory MITRE Intermountain Healthcare Strata Decision Technology Salesforce.com Awesome Problem Genialis Avecin Veradigm Surgo Foundation SAP KPN GoInvo Amazon Web Services Amazon Web Services Symphony Ayasdi SAS LabCorp Google Caresyntax SUPPLY CHAIN BlackThorn Therapeutics Tableau SCP Health Leidos Health Group Greenway Health Center for Mind and Culture Apervita Brainworks.ai TensorX SEI MITRE hc1 COVID SafePaths athenahealth BurstIQ Teradata Health Catalyst Deloitte Atlas Research NACDS Topo.ai CONVALESCENT PLASMA Change Healthcare Health Gorilla Fusion Consulting Avery Dennison Medical Nference Traction & Scale Cerner Corporation CitiusTech IBM Watson Health Genentech Aviv Growth Partners Prism Health AI TREND Community Epic Systems Corporation Cox Business Informatica Georgia Tech Research Institute Amazon Web Services SparkBeyond Uncharted Software Mayo Clinic DXC Technology Innovu Google Aya Healthcare Unite Us MITRE Genentech Inc VENTILATOR SUPPLY CHAIN Insilico Medicine Intermountain Healthcare California Institute of Technology University of Maryland Sachs Policy Group Google Instant Access Medical Holdings Limited Lumeris Cardinal Health Aviv Growth Partners University of Mississippi Medical Center Intel Corporation COVID-19 TELEHEALTH MITRE Caresyntax HCA Healthcare MITRE Vcinity Intelligent Medical Objects IMPACT STUDY Nference CitiusTech Health Level Seven International Nightingale Partners XIFIN Intermountain Healthcare American Telemed (ATA) Nutanix Clinical Architecture Intel Corporation Change Healthcare Old Dominion University Virginia Fusion Consulting Intermountain Healthcare MassChallenge Modeling, Analysis, and Simulation 12 Center c19hcc.org